The Harvard Community Health Plan (HCHP), a prepaid group practice, and the Laboratory of Computer Science (LCS), a research and development organization, have jointly developed the Computer-Stored-Ambulatory-Record, a unique, totally computerized information system which functions primarily as the patient record at HCHP but also has management and administrative functions. It is the purpose of this research project to develop and test quality assurance applications of this record system. The broad objectives of this proposal as outlined in the original grant application are: 1. To develop as an integral component of the health care delivery system a quality assurance program which can serve as a model for other organizations attempting quality assessment in the ambulatory care area, and specifically to help other health maintenance organizations prepare programs that will meet the requirements of the HMO Act of 1973. 2. To demonstrate the usefulness of a computerized record system in monitoring compliance with standards. 3. To document the impact of feedback to the provider regarding inadequate compliance with agreed upon standards. More specifically, the goals of the program include carrying out quality assurance projects in each of the major departments of the Kenmore Center of HCHP, developing explicit criteria among providers of care which are easily auditable in the computerized record, selecting outcome criteria wherever possible, attempting to correlate process criteria with outcome criteria, and measuring the measuring the impact of programs on the quality and cost of care. BIBLIOGRAPHIC REFERENCES: Barnett, G.O., Winickoff, R., Dorsey, J.L. & Morgan, M.M.: The role of feedback in quality assurance--an application of a computer-based ambulatory medical information system. proc. of the 1976 American Society ofInternal Medicine Conference on "Assessing Physician Performance in Ambulatory Care", June 18-19, 1976, San Francisco, pp. 140-156, 1976.